NPI | 1588366587 |
---|---|
Former Name | JESSICA A BEAUCHAMP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MI 4704377406) |
Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: WI 13728-33) |
Enumeration Date | 2023-03-21 |
Last Update Date | 2023-04-05 |